Provider Demographics
NPI:1063466589
Name:COLUMBIA HOSPITAL CORPORATION OF SOUTH BROWARD
Entity Type:Organization
Organization Name:COLUMBIA HOSPITAL CORPORATION OF SOUTH BROWARD
Other - Org Name:HCA FLORIDA WESTSIDE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-476-3987
Mailing Address - Street 1:8201 W BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2701
Mailing Address - Country:US
Mailing Address - Phone:954-473-6600
Mailing Address - Fax:954-452-2133
Practice Address - Street 1:8201 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2701
Practice Address - Country:US
Practice Address - Phone:954-473-6600
Practice Address - Fax:954-452-2133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
5002025OtherUNITED HEALTH CARE
FL000030908OtherHUMANA
NY00864411Medicaid
FL011230500Medicaid
20237OtherWELLCARE/STAYWELL
FL281OtherBLUE CROSS
FL011230500Medicaid
FL000030908OtherHUMANA